A Letter from Paul Wallner

[TheWallnerus]

I don't really want to wind up like Julian Assange. Can't reveal my sources. Don't ask, can't tell, and all that, old chap. But this is a 100% verified real personal email to a real board-certified radiation oncologist. The email was sent over a post or posts made by this radiation oncologist on ROHub and Twitter. So with further ado...


Dear XXXXXX:

I have read with some concern your recent posting on XXXXXX. Although I can understand the frustration and concern many residents and candidates currently have regarding the initial certification assessment instruments of the ABR, especially in these difficult times, I find it especially troublesome when those views are expressed with little or no information of the actual processes involved or decision-making. I am especially distressed when the attacks become personal against me, and clearly from one who has no knowledge of any of the facts of which he writes.

With regard to the issue of accommodations for female candidates, the initial posting that started the torrent of subsequent postings was based on totally incorrect information. The ABR goes to great lengths to accommodate all candidates with special needs, including nursing or breast pumping females.

With regard to the performance of candidates in physics and biology on the 2018 exams, you suggest that the ABR "has blamed" the residents. In fact, the great majority of candidates who took those exams passed with high grades, and those who failed did so abysmally. They simply did not know the material. If that is "blaming," so be it! You also suggest that somehow those single year grades have had some impact on the specialty. Actually, if you took the time to investigate the facts, you would see that applications and quality of applicants had begun to drop well before the 2018 exams were ever administered.

I find your statement regarding separation of radiation oncology from the ABR even more misguided. ABR certification exams are developed ONLY by radiation oncologists and all decisions regarding those exams are made by radiation oncologists. The fees of the 10x number of diagnostic radiology candidates and diplomates actually support the radiation oncology endeavor, which, in fact, is a money losing proposition for the ABR. If the radiation oncology community, with a fervor driven by inappropriate posts such as yours, should ever intend to actually "control our own destiny," I would guess that the cost to residents and diplomates could be more than double the current levels, with a significantly diminished end-product.

Even more troublesome, and personally abhorrent to me, are the essentially libelous statement about me and my employer, 21st Century Oncology, Inc. that you have made on a public, professional website. You have absolutely no knowledge of me, my responsibilities with that entity, or the legal facts of the issues you raised, and the implication that I was somehow involved is not only factually incorrect, but apparently maliciously intended. If such statements continue, I will have little choice but to react as necessary.

Paul E. Wallner, DO

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[KHE88]

With regard to the performance of candidates in physics and biology on the 2018 exams, you suggest that the ABR "has blamed" the residents. In fact, the great majority of candidates who took those exams passed with high grades, and those who failed did so abysmally. They simply did not know the material. If that is "blaming," so be it! You also suggest that somehow those single year grades have had some impact on the specialty. Actually, if you took the time to investigate the facts, you would see that applications and quality of applicants had begun to drop well before the 2018 exams were ever administered.

Even more troublesome, and personally abhorrent to me, are the essentially libelous statement about me and my employer, 21st Century Oncology, Inc. that you have made on a public, professional website. You have absolutely no knowledge of me, my responsibilities with that entity, or the legal facts of the issues you raised, and the implication that I was somehow involved is not only factually incorrect, but apparently maliciously intended. If such statements continue, I will have little choice but to react as necessary.

Paul E. Wallner, DO

"great majority of candidates who took those exams passed with high grades, and those who failed did so abysmally."

Patently false. Somewhere between 35-50% failed at least one exam. He has all the hallmarks of a pathologic liar.

" you would see that applications and quality of applicants had begun to drop well before the 2018 exams were ever administered."

Another outright lie. His bias on this has been well demonstrated in the old physics and rad bio thread where he was called out for publishing articles years prior suggesting inferior resident quality and training at small programs with no evidence to support this.

"I will have little choice but to react as necessary."

Of course this d-bag is threatening a libel lawsuit if you don't shut up. Because of course he is.

Really hope this is trolling, but this is basically 100% consistent with everything I've heard firsthand about how this jerk communicates with people.

 

[Gfunk6]

Thanks for posting this and thanks scarbrtj for taking a screenshot for posterity (things are rampantly being deleted nowadays).

This letter displays open hostility, a complete lack of empathy, absolutely zero humility, and lacks self-reflection. It is emblematic of the entrenched, pitiless, and over-privileged bureaucracy that sits high in Radiation Oncology. The time is long past to tip it over.

 

[scarbrtj]

Thanks for posting this and thanks scarbrtz for taking a screenshot for posterity (things are rampantly being deleted nowadays).

This letter displays open hostility, a complete lack of empathy, absolutely zero humility, and lacks self-reflection. It is emblematic of the entrenched and pitiless bureaucracy that sits high in Radiation Oncology. The time is long past to tip it over.

I did take a screen shot --- "word on the street": this is a real email, not a joke or troll etc. "Entrenched and pitiless"... yes

 

[w00tz]

Sure, Wallner, let's stick with the ABR. We just need to get rid of YOU. You are our biggest problem.

 

[Mandelin Rain]

Well, at least we know who wrote the letter for Steinberg. Seriously, basically the same content. Almost the same phrasing save the more hyperbolic statements.

 

[OTN]

This is going to be fun!


Dear XXXXXX:

I have read with some concern your recent posting on XXXXXX. Although I can understand the frustration and concern many residents and candidates currently have regarding the initial certification assessment instruments of the ABR, especially in these difficult times, I find it especially troublesome when those views are expressed with little or no information of the actual processes involved or decision-making. I am especially distressed when the attacks become personal against me, and clearly from one who has no knowledge of any of the facts of which he writes. (I PLAN ON TAKING NO PERSONAL RESPONSIBILITY AS ONE OF THE LEADERS OF THE ABR)

With regard to the issue of accommodations for female candidates, the initial posting that started the torrent of subsequent postings was based on totally incorrect information. The ABR goes to great lengths to accommodate all candidates with special needs, including nursing or breast pumping females. (GIVEN WHAT WE'VE HEARD DIRECTLY FROM WOMEN WITH THESE NEEDS AND THEIR INTERACTION WITH THE ABR, THIS IS A BLATANT LIE)

With regard to the performance of candidates in physics and biology on the 2018 exams, you suggest that the ABR "has blamed" the residents. In fact, the great majority of candidates who took those exams passed with high grades (ANOTHER BLATANT LIE, AS MENTIONED ABOVE), and those who failed did so abysmally (WHAT DOES THAT EVEN MEAN? THAT THERE WAS A BIMODAL DISTRIBUTION OF SCORES? I DOUBT THAT. HIGHLY.) They simply did not know the material. If that is "blaming," so be it! (IT IS BLAMING. WHAT ELSE WOULD IT BE? DO YOU HAVE EXTRA QUOTATION MARKS LYING AROUND SOMEWHERE YOU NEED TO GET RID OF?) You also suggest that somehow those single year grades have had some impact on the specialty. (INTERESTED MEDICAL STUDENTS WATCHING RESIDENTS FREAK OUT OVER A BS BIOLOGY EXAM THAT SHOULDN'T EVEN BE PART OF BOARD CERTIFICATION WOULDN'T IMPACT A SPECIALTY ALREADY TEETERING ON THE BRINK OF DISASTER? ON WHAT PLANET?) Actually, if you took the time to investigate the facts, you would see that applications and quality of applicants had begun to drop well before the 2018 exams were ever administered. (HE DIDN'T SAY QUALITY HADN'T DROPPED PRIOR TO 2018. HE WAS JUST SAYING THE DECISIONS THE ABR MADE FURTHER IMPACTED THE SPECIALTY.)

I find your statement regarding separation of radiation oncology from the ABR even more misguided. ABR certification exams are developed ONLY by radiation oncologists and all decisions regarding those exams are made by radiation oncologists. The fees of the 10x number of diagnostic radiology candidates and diplomates actually support the radiation oncology endeavor, which, in fact, is a money losing proposition for the ABR. If the radiation oncology community, with a fervor driven by inappropriate posts such as yours, should ever intend to actually "control our own destiny," I would guess that the cost to residents and diplomates could be more than double the current levels, with a significantly diminished end-product. (HE WOULD GUESS, BUT HE REALLY HAS NO IDEA, DOES HE? HIS RATIONALE MAKES SENSE, THOUGH, AS NEUROSURGEONS (FEWER OF THEM THAN US) STILL ARE UNDER THE BOARD OF NEUROLOGISTS, RIGHT? RIGHT??)

Even more troublesome, and personally abhorrent to me, are the essentially libelous statement about me and my employer, 21st Century Oncology, Inc. that you have made on a public, professional website. You have absolutely no knowledge of me, my responsibilities with that entity, or the legal facts of the issues you raised, and the implication that I was somehow involved is not only factually incorrect, but apparently maliciously intended. If such statements continue, I will have little choice but to react as necessary. (TRYING TO TAKE THE HIGH GROUND AS A 21C EXECUTIVE. BOLD MOVE, COTTON. HOW MANY TENS UPON TENS OF MILLIONS OF DOLLARS HAS 21C HAD TO PAY IN PENALTIES OVER THE LAST DECADE? IS IT AT $100 MILLION YET?)

 

[Mandelin Rain]

Too much baggage. Time to move on.

 

[KHE88]

Wallner is a virus. He's infected radiation oncology like herpes. Will never go away and pops his ugly head up every once in a while to ruin your life for no reason. And sure makes it hard to attract others to your field when you're infected with the Wallner.

#cancelwallner

 

[RadOncLazers]

This is reason enough to move away from the ABR. It demonstrates complete deafness to our concerns.

 

[metallica81788]

If most of the country now can get leaders/employees/students anyone removed for borderline controversial comments or actions, why can we as a group not get him out? This is not borderline. There has never been a better time, albeit late.

 

[seper]

old-time Radoncs love to threaten with litigation. I’ve worked with at least three 60-somethings like that. They never bite, just bark


Sent from my iPhone using Tapatalk

 

[Haybrant]

Can we get some more clarity on exactly who Wallner is, what role does he hold (and is it a lifetime position Or something?) so we can target the right people regarding this

 

[radiaterMike]

There seems to be abundant whining and inaccuracies in that letter, but it does not come across as heinous to an impartial/uninformed reader. Didn't he write an email to the resident who voiced concern over the ABR's inflexibility in accommodating pregnant and breastfeeding examinees ? The rumor (on this board) was that letter resulted in emergency meeting. That letter (if it exists) would be more damning.

 

[elementaryschooleconomics]

Can we get some more clarity on exactly who Wallner is, what role does he hold (and is it a lifetime position Or something?) so we can target the right people regarding this

Sure -

Current Associate Executive Director at the ABR: ABR

Appointed in 2009: ABR taps Wallner for executive director

Seems like a lifetime appointment? I've never seen language to indicate otherwise. For instance, Valerie Jackson chose to retire after 6 years: ABR

Current Senior Vice President of 21st Century Oncology: Paul E. Wallner - 21st Century Oncology

Since 2004: Paul E. Wallner, MD | Senior Vice President

Here's more about the Associate Executive Director role: ABR

Key language: " AEDs are members of our staff, not our board. They are paid for their work and they answer to the executive director."

 

[Mandelin Rain]

There seems to be abundant whining and inaccuracies in that letter, but it does not come across as heinous to an impartial/uninformed reader.

Yeah. I thought this might be worse.

 

[elementaryschooleconomics]

There seems to be abundant whining and inaccuracies in that letter, but it does not come across as heinous to an impartial/uninformed reader. Didn't he write an email to the resident who voiced concern over the ABR's inflexibility in accommodating pregnant and breastfeeding examinees ? The rumor (on this board) was that letter resulted in emergency meeting. That letter (if it exists) would be more damning.

Correct. I think those of us who are regulars on SDN know who received the letter posted by OP in this thread. I think the more concerning one is still "in the wind". I have talked to many people over the last few weeks (in real life) who are aware of that email but have not personally seen it. I imagine that the person who received that email - as well as those that were CC'ed on it - have just spoken about it, not shared it.

 

[elementaryschooleconomics]

Correct. I think those of us who are regulars on SDN know who received the letter posted by OP in this thread. I think the more concerning one is still "in the wind". I have talked to many people over the last few weeks (in real life) who are aware of that email but have not personally seen it. I imagine that the person who received that email - as well as those that were CC'ed on it - have just spoken about it, not shared it.

I think this passage indicates this:

" With regard to the issue of accommodations for female candidates, the initial posting that started the torrent of subsequent postings was based on totally incorrect information. The ABR goes to great lengths to accommodate all candidates with special needs, including nursing or breast pumping females. "

I imagine an email was sent to the person who made the "initial posting" on Twitter. Hopefully we'll see that email one day.

 

[metview]

Someone should post to twitter so the world can see how malignant he is.

 

[deleted480308]

How does your board of governors/trustees get filled? Does the whole membership vote or is it the current folks appointing friends?

 

[KHE88]

Hopefully this will encourage the rad onc who received the threatening/intimidating email from wallner regarding pregnancy concerns to leak/post it along with the numerous others who have been the victim of this sociopathic jerk's ire.

Numerous posters here have indicated a willingness to post leaked emails, myself included. PM me with anything and identifying info will be stripped and posted. It really needs to be done.

 

[medgator]

old-time Radoncs like to threaten with litigation. I’ve works with at least three 60-somethings like that. They never bite, just bark


Sent from my iPhone using Tapatalk

Sounds like someone else we all know....

 

[deleted774703]

Despicable email by Wallner. Guy got in when you could make a 98 on Step 1. He needs to STFU

If the female attending who received a similar email posts, then he will be done.

 

[hbosch]

Not sure what he wants to be remembered for, but he just solidified his legacy in the above letter. And way to encourage promising medical students that this is what you’re walking into if you dare express an opinion about the field. Its already a complete mess with a lack of jobs, and you want to start threatening residents and new attendings for existing and speaking? Thank you Paul Wallner- perhaps your ultimate goal is to help the field by convincing people to not go in the field, thereby improving the job market in 5 years. Thank you, you brilliant man. We have all underestimated you and your dedication to our field.

Shouldn’t he have stated in that letter that his opinion doesn’t reflect the opinion of his employers in case the people who received the letter should choose to sue him for threatening them, causing undue mental harm, and if he’s going to threaten to sue that means he may want to try and harm them from future employment.

We have a very caustic field. Sad!!!

 

[Radonc90]

Excerpt from a Full Professor on ROHub around June 8, 2020:
"... At this point Radiation Oncology is as different from Radiology as Neurosurgery is to General Surgery. Hopefully, this will motivate our field to come together and form our own board. We cannot control our own destiny unless we are fully independent..."

So, Wallner attacked a Full Professor, not just some fresh grads or junior attendings.
Trust me, go to ROHub and read it for yourself.

Wallner should be impeached by at least 3 articles, not 2.

 

[Gfunk6]

Trust me, go to ROHub and read it for yourself.

Unfortunately, there is nothing left to read on ROHUB. ASTRO runs it like the North Korean News Service. Any post which doesn't conform to "#radoncrocks" is promptly deleted. It doesn't matter if that post is made by a medical student or founding member of ASTRO.

Twitter is not much better with a few exceptions. People post things, suddenly realize the political backlash it may cause with Big Brother, and swiftly delete. SDN is your unabridged source of truth.

 

[Radonc90]

The kitchen is too hot for Wallner.
He should leave the kitchen...
Time for young good people to run ABR.

I wish Robert Lee is in charge of ABR. Lee has strong ethics and can stand up to the big boys.

 

[scarbrtj]

Even more troublesome, and personally abhorrent to me, are the essentially libelous statement about me and my employer, 21st Century Oncology, Inc. that you have made on a public, professional website. You have absolutely no knowledge of me, my responsibilities with that entity, or the legal facts of the issues you raised, and the implication that I was somehow involved is not only factually incorrect, but apparently maliciously intended. If such statements continue, I will have little choice but to react as necessary.

So here's a question. And as an ABR diplomate, I'd like an answer from Wallner himself. I think there's a reasonable chance he's... not being 100% truthful.

One of 21c's settlements (for $35m) was for this "GAMMA" thing. In brief, they extend the MV imager on the linac into the exit beam path while the beam is treating. It captures the dose, they compare that with expected. (It's in the Eclipse or ARIA software; you can kind of think of it like IMRT QA but instead of a phantom it's the patient.) They bill a basic dosimetry. For every beam. IMRT, 3D, curative, mets, whatever. Every week. Now what I think we can all agree on: don't do that. And if you are doing it, stop. It's of zero clinical benefit at least. No one besides 21c was doing this nationally.

But what if 21c is still doing it?

According to Ting, the whistleblower, they still are. "21st Century did not admit wrongdoing and said in a statement that it believes in the test and will continue to use it." I mean right there, to "believe" in it... fine. Believe in it. But don't bill it. Now if Wallner is still working at 21c, and they're still doing this, then he is engaging in the exact same thing that was involved in the settlement. And it's tough to swallow that he is the lone guy at 21c who didn't "believe in the test." And, legal or not, or fraud or not, or whatever legal angle, I think we all as reasonable radiation oncologists would look at someone who is doing this as someone we would not want to head the ABR. I mean, let him treat, but head the ABR? And whatever his "responsibilities" are, he treats patients at 21c. And *all* his treated patients had the "GAMMA," for sure, prior to 2016. It was company policy, no exceptions allowed.

I think some of you out there may know some current ongoing workings of 21c. Are they still doing basic dosim charges on every beam, every patient, every week, by doing that silly GAMMA? Please find out. Please say they aren't. Maybe that's why govt has such a hard on for APM?!?

 

[goodkerma]

 

[thecarbonionangle]

Lord Wallrus,

please get this Wallner letter harassing breast feeding attendings.

wallner has to go!

 

[deleted774703]

With regard to the performance of candidates in physics and biology on the 2018 exams, you suggest that the ABR "has blamed" the residents. In fact, the great majority of candidates who took those exams passed with high grades, and those who failed did so abysmally. They simply did not know the material. If that is "blaming," so be it! You also suggest that somehow those single year grades have had some impact on the specialty. Actually, if you took the time to investigate the facts, you would see that applications and quality of applicants had begun to drop well before the 2018 exams were ever administered.

Wonder what Wallnerus and his UCLA puppet would say after seeing the data...

 

[scarbrtj]

Wonder what Wallnerus and his UCLA puppet would say after seeing the data...

Maybe rad onc began seeing an uptick in the number of low-USMLE-score applicants. Whereas the overall average of everyone was rising, the number of "low qual" applicants might have risen from 1% to 5% or something. That would be noticeable. Still, very unfair to taint the whole group with the broad brushstroke of "declining applicant quality." When obv the whole group was not declining in quality.

This is a WAG by me to give Wallner benefit of doubt, The alternative is that Wallner is fabricating/superwrong.

 

[thecarbonionangle]

The funny thing is Wallner walked into RO with a pulse and now he lectures people on “declining quality” and “abysmal” knowledge of rad bio. A majority of people failed at least one exam that year. Maybe Wallner was onto something with some people, maybe he was not, but certainly unfair to tarnish the whole class as know nothings which is precisely what Kachnic and Wallner did.

 

[deleted774703]

This is a WAG by me to give Wallner benefit of doubt, The alternative is that Wallner is fabricating/superwrong.

Can I like this part twice haha

 

[KHE88]

Do not believe the ABR's lies whether they are coming from known liar/epic gaslighter Wallner or stooges/cronies.

Bullying and intimidation tactics and cartel-like behavior need to end.

Need strong fresh leadership to put an end to this for good. Breaking from the ABR is the only way.

 

[KHE88]

Wonder what Wallnerus and his UCLA puppet would say after seeing the data...

Will point back to his biased 2014 publication he pulled out his butt and focus on his hatred of small midwest programs based on literally nothing.

 

[thecarbonionangle]

classic. “Hold your nutz, guard your grill cause its hatin’ season”

 

[Mandelin Rain]

Guys, he cited Wikipedia. So... you know, he can’t be wrong.

 

[scarbrtj]

Pandemic Causes Tough Exam Administration Decisions
by Paul E. Wallner, DO, FASTRO, Associate Executive Director for Radiation Oncology, and David Laszakovits, MBA, Director of External Relations

 

[Radonc90]

Make sure you follow PW (well Waller haha) on twitter....

https://twitter.com/PaulWallerdo

 

[thecarbonionangle]

When will the specialty rid itself of this goon? Never!!